title: Atypical autonomic dysreflexia during robotic-assisted body weight supported treadmill training in an individual with motor incomplete spinal cord injury.
abstract: OBJECTIVE
  A 41-year-old man with a history of C6 American Spinal Injury Association (ASIA) Impairment Scale (AIS) C spinal cord injury (SCI), enrolled in an Institutional Review Board (IRB)-approved, robotic-assisted body weight-supported treadmill training (BWSTT), and aquatic exercise research protocol developed asymptomatic autonomic dysreflexia (AD) during training. Little information is available regarding the relationship of robotic-assisted BWSTT and AD.
  
  
  RESULTS
  After successfully completing 36 sessions of aquatic exercise, he reported exertional fatigue during his 10th Lokomat intervention and exhibited asymptomatic or silent AD during this and the three subsequent BWSTT sessions. Standard facilitators of AD were assessed and no obvious irritant identified other than the actual physical exertion and positioning required during robotic-assisted BWSTT.
  
  
  CONCLUSIONS
  Increased awareness of potential silent AD presenting during robotic assisted BWSTT training for individuals with motor incomplete SCI is required as in this case AD clinical signs were not concurrent with occurrence. Frequent vital sign assessment before, during, and at conclusion of each BWSTT session is strongly recommended.
authors.affiliation: Kernan Orthopaedic and Rehabilitation Hospital, Baltimore, MD, USA. pgeigle@kernan.umm.edu
authors.forename: Paula R
authors.initials: PR
authors.lastname: Geigle
authors.forename: Sara Kate
authors.initials: SK
authors.lastname: Frye
authors.forename: John
authors.initials: J
authors.lastname: Perreault
authors.forename: William H
authors.initials: WH
authors.lastname: Scott
authors.forename: Peter H
authors.initials: PH
authors.lastname: Gorman
mesh_terms: D000328:Adult; D020211:Autonomic Dysreflexia / Q000209:etiology* / Q000503:physiopathology; D001835:Body Weight; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D012371:Robotics / Q000379:methods*; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D016474:Weight-Bearing